American Journal of Medical Sciences and Medicine
ISSN (Print): 2327-6681 ISSN (Online): 2327-6657 Website: http://www.sciepub.com/journal/ajmsm Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Medical Sciences and Medicine. 2013, 1(2), 24-27
DOI: 10.12691/ajmsm-1-2-2
Open AccessArticle

Comparing the Efficacy of Oral Sucrose and Acetaminophen in Pain Relief for Ophthalmologic Screening of Retinopathy of Prematurity

Fatemeh Seifi, Ali Peirovifar and Manizheh Mostafa Gharehbaghi,

Pub. Date: April 11, 2013

Cite this paper:
Fatemeh Seifi, Ali Peirovifar and Manizheh Mostafa Gharehbaghi. Comparing the Efficacy of Oral Sucrose and Acetaminophen in Pain Relief for Ophthalmologic Screening of Retinopathy of Prematurity. American Journal of Medical Sciences and Medicine. 2013; 1(2):24-27. doi: 10.12691/ajmsm-1-2-2

Abstract

Retinopathy of prematurity (ROP) is a potential cause for visual impairment in preterm newborn infants with gestation age 32 weeks or less and birth weight less than1500 gram. There are several studies that reported physiologic and behavioral responses to painful and stressing screening examination. This study was conducted to compare the efficacy of sucrose and acetaminophen in pain control during eye examination in premature infants. A prospective randomized clinical trial was carried out in a tertiary level NICU. One hundred twenty preterm infants were randomly allocated in to 3 groups. Group A received oral acetaminophen 15mg/kg 30 minutes before eye examination and 0.2ml sterile water, given by mouth using a syringe, during examination; group B 0.2ml sucrose 25% and group C 0.2ml sterile water given by mouth using a syringe during examination. Ophthalmologic examinations were recorded by videotape. Pain score was determined by using PIPP during first 45 seconds and at last 45 seconds of eye examination. There was no significant difference between groups regarding gestation age, birth weight and age at examination. The mean PIPP score at first 45 sec were 12.9±2.4, 9±2.1 and 13.7±1.6 for groups A, B, and C respectively (p<0.001). It was 12.3±2.4, 11.2±3 and 12.1±2.6 at last 45 sec of examination in groups A, B, and C respectively P=0.12.Two patients had apnea during first 12 hours after examination and both of them were in group C. In our study, using sucrose was associated with reduced pain score in neonates undergoing screening for ROP at beginning of eye examination but not at the last seconds of examination.

Keywords:
retinopathy of prematurity pain preterm neonates PIPP

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Wheathey CM, Dickinson JL, Mackey DA, Craig JE, Sale MM. Retinopathy of prematurity: recent advances in our understanding. Br J Ophthalmol. 2002; 86(6):696-700.
 
[2]  Porter FL, Lueder G. Anesthetized retinopathy of prematurity examinations elicit significant physical instabilityin premature infants. Pediatr Res 1997; 41 (4):170-170.
 
[3]  Rush R, Rush S, Nicolau J, Chapman K, Naqui M. Systematic manifestations in response to mydriasis and physical examination during screening for retinopathy of prematurity. Retina 2004; 24(2):242-245.
 
[4]  Mehta M, Adams GGW, Bunce C, XingW, Hill M. Pilot study of systematic effects of three different screening methods used for retinopathy of prematurity. Early Dev 2005; 81(4):355-360.
 
[5]  Craig KD, Whitfield MF, Grunau RV, Linton J, Hadjistavropoulos HD. Pain in the pre term neonates:behavioral and physiologic indices. Pain 1993; 52 (3):287-299.
 
[6]  Nair AK, Pai MG, da Costa DE, Khusaiby SM. Necrotizing enterocolitis following ophthalmologic examination in preterm neonates. Indian Pediatr 2000; 37 (4):417-421.
 
[7]  Bonthala S, Sparcks JW, Musgrove KH, Berseth CL. Mydriaticsslows gastric emptying in preterm infants. J Pediatr 2000; 137(3):327-330.
 
[8]  Bhutta AT, Anand KJS.Vulnerarability of the developing brain:neuronal mechanisms. ClinPerinatol 2002; 29 (3):357-372.
 
[9]  Grunau R. Early pain in preterm infants: a model of long term effects. ClinPerinatol. 2002; 29 (3):373-394.
 
[10]  Samra HA, Mc Grath JM.Pain management during retinopathy of prematurity eye examinations.A systematic review. Adv Neonatal Care 2009; 9 (3):99-110.
 
[11]  Abu-Saad HH, Bours GJJW, Stevens B, Hamers JPH. Assessment of pain in the neonate:.SeminPerinatol 1998; 22 (5):402-416.
 
[12]  Stevens BJ, Johnstone CC. Physiological responses of premature infants to a painful stimulus.Nurs Res 1994; 43 (40):226-231.
 
[13]  Leslie A, Marlow N. Non pharmacological pain relief.Semin Fetal Neonatal Med. 2006; 11(4):246-250.
 
[14]  Slarter R, CornelissenL,FabriziL,Patten D, Yoxen J, Worley A, et al. Oral sucrose as an analgesic drug for procedural pain in newborn infantsa randomized controlled trial. Lancet 2010; 379 (9748):1225-1232.
 
[15]  Pinelli J, Symington AJ. Non nutritive sucking for promoting physiologic stability and nutrition in pre term infants. Cochrane Database Sys Rev.2005; 4. Art. No.:CD001071.
 
[16]  Alegaert K, Van der Marel CD, Debeer A, PluimMAL, VanLingen RA, Vanhole C, et al. Pharmacokinetics of single dose intravenous propacetamol in neonates: effect of gestational age. Arch Dis Child Fetal Neonatal Ed 2004; 89:F25-F28.
 
[17]  Hall RW, ShbarouRM .Drugs of choice for sedation and analgesia in NICU.ClinPerinatol 2009; 36 (1):15-26.
 
[18]  Anderson BJ, Van LingenR,Tom H, Yuan-Chi L, Nicholas H.Acetaminophen developmental pharmacokinetics in premature neonates and infants:a pooled population analysis. Anesthsiol 2002; 96(6)1336-1345.
 
[19]  O,Sulivan A, O,Connor M, Brosnahan D, Mc Creery K, Dempsey EM. Sweeten soother and swaddle for retinopathy of prematurity screening: a randomized placebo controlled trial. Arch Dis Child Fetal Neonatal Ed 2010; 95(6): F419-F422.
 
[20]  Gal P, Kissling GE, Young WO, .efficacy of sucrose to reduce pain in premature infants during eye examination for retinopathy of prematurity. Ann Pharmacother 2005; 39:1029-1033.
 
[21]  Grabska J, Walden P, LererT, Kelly C, Hussain N, Donovan T, et al. can oral sucrose reduces the pain and distress associated with screening for retinopathy of prematurity? J Perinatol 2005; 25:33-35.
 
[22]  Mitchell A, Stevens B, Mungan N, Johnson W, Lobert S, Boss B. Analgesic effects ofsucrose and pacifier during eye examinations for retinopathy of prematurity. Pain Management Nursing 2004; 5(4):160-168.
 
[23]  Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev 2010; 1. Art. No.:CD001069.
 
[24]  Johnson CC, Filion F, Snider L, et al. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks, post conceptional age. Pediatrics 2002; 5(4):160-168.
 
[25]  Stevens B, Yamada J, Beyene J,et al. Consistent management of repeated prodeural pain with sucrose in preterm neonates: is it effective and safe for repeated use over time? Clin J pain 2005; 21(6):543-548.
 
[26]  Taddio A, Shah V, Atenafu E, Katz J.Influence of repeated painful procedures and sucrose analgesia on the development of hyperalgesia in newborn infants. Pain 2009; 144 (1-2):43-48.
 
[27]  Caspardo CM, Miyae CI, Chimello JT, Martinez FE, MartusLinhares MS. Is pain relief equally efficacious and free of side effects with repeated doses of oral sucrose in preterm neonates? Pain 2008; 137(1):16-25.
 
[28]  Shah V, Taddio A, Ohlsson A. Randomized controlled trial of paracetamol for heel prick pain in neonates. Arch Dis Child Fetal Neonatal Ed.1998; 79: F209-F21.